The 2011 Steven Soderbergh film, Contagion, was scary and featured a stellar ensemble cast. Its poster had the line, “nothing spreads like fear”. The story begins, as all pandemics do, with an unsuspecting index patient who dies. But by then the process, the contagion, has begun.
It was while watching that film that I was introduced to the term, basic reproduction number or R0 (pronounced R-naught). R0 is the number epidemiologists use to determine “the number of cases, on average, an infected person will cause during their infectious period.”
But films, even when scary, are only films. One is removed from what is happening and there is a sense of make-believe about events. It’s like violence; someone shoots another in the head and moves on to shoot many more. It’s different from witnessing the same violence in real life. And while Contagion didn’t require willing suspension of disbelief since pandemics are a fact of life — recall the 14th Century Black Death, the 1918 Spanish Influenza or the more recent SARS, Ebola, H1N1 epidemics — those pandemics didn’t impact everyday life and they happened elsewhere.
Covid 19 is right here, in our homes.
That’s where other factors come in, as they did in Contagion. There are those who are feverishly trying to find a cure; there are others who want to create further panic and profit off it; there are the rising numbers of patients that put incredible stress on healthcare systems and services; there is the requirement of quarantining whole cities (Chicago in the film); there’s the breakdown of social fabric and law and order (looting, violence); there’s the breakdown of cooperation with people tending for themselves and the societal and civilisational veneer coming off.
In other words, just when one needs more cooperation, society falls into murderous selfishness. And just like in war and famine and other disasters, economies get destroyed but some sectors and some people make a killing.
That’s when our everyday moral and ethical categories and values are tested and, in most cases, found wanting. Perfectly sane people can become cannibals (there are records of that during famines); neighbours kill each other (civil wars are a testimony to that); the weak and the fragile and the infected are expended because everything is scarce and we need to triage.
Life becomes a real-life trolley experiment.
But back to Covid-19, the non-celluloid, real contagion.
We are not just under-prepared for its trajectory, we are unprepared, period. The reason is simple: we have never really invested in the health and education sectors and we have a burgeoning, semi- to fully illiterate population that is not prepared for any such contingency. The state’s coffers are empty and its bureaucracy, long attuned to doing things according to outmoded templates, is not equipped for the challenge. Our non-existent healthcare system has thus near-zero capacity to deal with a contagion and its spread.
This should be obvious in relation to far more advanced systems that have, as in the case of Italy, all but collapsed. We also have a population that is religiously stoic and fatalistic. That, given the levels of education, make for an explosive scenario.
Add to that other unknowns. For instance, the R0 in this case. The number “represents the maximum epidemic potential of a pathogen.” The effective reproduction number can be lower and depends on the “population’s current susceptibility.” Studies show that both the basic and effective R0s are situation-dependent.
“[They are] affected by the properties of the pathogen, such as how infectious it is. It’s affected by the host population – for instance, how susceptible people are due to nutritional status or other illnesses that may compromise one’s immune system. And it’s affected by the environment, including things like demographics, socioeconomic and climatic factors.”
Clearly, some of these factors can lead to a rise in the trajectory while others could help suppress it. But, in our case, none of it will — for the most part — be guided through rational policy. In other words, if the curve rises, there’s not much we can do except wait for herd immunity to kick in while x numbers die; if it begins to flatten, it won’t be because we managed some scientific intervention to that end.
Put bluntly, we are exposed.
That said, and knowing how feeble our policy responses would be in this round, are there any lessons? Surely, destruction of any kind should also be a learning curve. Rethinking the idea of security and broadening its definition. Pathogens cannot be stopped through a military response. If anything, they can stretch the militaries and law enforcement. They are fought, foremost, in the labs by people wearing white coats.
These people do unsexy work. You can’t put them on a float at a useless 23rd March parade; they can’t do a thrilling aerobatics show or skydive from 10,000 feet; hell, they can’t even march and salute you. They don’t wear flight suits or camouflage.
But they are the real saviours. How many of them we have here? I wonder. How many labs are doing cutting-edge biotech research, nanotech, genetics et cetera. I really wonder.
And if there are not many, which is what I suspect, then we need to go back to our schools and take a good, hard look at both our syllabi and our teaching methods. Are we nurturing talent that will give us these leaders? Have we invested in this? Ditto for the health sector. Statistics about how many beds, ICUs and ventilators we currently have are just one glimpse into what we have, or do not. There are several other factors underlining this pathetic state.
What’s ironic is that, as the world is unfolding, we can’t even have traditional, hard security if we do not begin investing in these two sectors.
I don’t know what the toll of Covid-19 will be. But this too will pass. What will stay, however, will be the lessons we have learned. If we go back to navel-gazing, as normally happens, we will be even less prepared for the next threat.
The writer is a former News Editor of The Friday Times and hates elusive pathogens. He reluctantly tweets @ejazhaider
It was while watching that film that I was introduced to the term, basic reproduction number or R0 (pronounced R-naught). R0 is the number epidemiologists use to determine “the number of cases, on average, an infected person will cause during their infectious period.”
But films, even when scary, are only films. One is removed from what is happening and there is a sense of make-believe about events. It’s like violence; someone shoots another in the head and moves on to shoot many more. It’s different from witnessing the same violence in real life. And while Contagion didn’t require willing suspension of disbelief since pandemics are a fact of life — recall the 14th Century Black Death, the 1918 Spanish Influenza or the more recent SARS, Ebola, H1N1 epidemics — those pandemics didn’t impact everyday life and they happened elsewhere.
Covid 19 is right here, in our homes.
That’s where other factors come in, as they did in Contagion. There are those who are feverishly trying to find a cure; there are others who want to create further panic and profit off it; there are the rising numbers of patients that put incredible stress on healthcare systems and services; there is the requirement of quarantining whole cities (Chicago in the film); there’s the breakdown of social fabric and law and order (looting, violence); there’s the breakdown of cooperation with people tending for themselves and the societal and civilisational veneer coming off.
In other words, just when one needs more cooperation, society falls into murderous selfishness. And just like in war and famine and other disasters, economies get destroyed but some sectors and some people make a killing.
That’s when our everyday moral and ethical categories and values are tested and, in most cases, found wanting. Perfectly sane people can become cannibals (there are records of that during famines); neighbours kill each other (civil wars are a testimony to that); the weak and the fragile and the infected are expended because everything is scarce and we need to triage.
Life becomes a real-life trolley experiment.
But back to Covid-19, the non-celluloid, real contagion.
We are not just under-prepared for its trajectory, we are unprepared, period. The reason is simple: we have never really invested in the health and education sectors and we have a burgeoning, semi- to fully illiterate population that is not prepared for any such contingency. The state’s coffers are empty and its bureaucracy, long attuned to doing things according to outmoded templates, is not equipped for the challenge. Our non-existent healthcare system has thus near-zero capacity to deal with a contagion and its spread.
This should be obvious in relation to far more advanced systems that have, as in the case of Italy, all but collapsed. We also have a population that is religiously stoic and fatalistic. That, given the levels of education, make for an explosive scenario.
Add to that other unknowns. For instance, the R0 in this case. The number “represents the maximum epidemic potential of a pathogen.” The effective reproduction number can be lower and depends on the “population’s current susceptibility.” Studies show that both the basic and effective R0s are situation-dependent.
“[They are] affected by the properties of the pathogen, such as how infectious it is. It’s affected by the host population – for instance, how susceptible people are due to nutritional status or other illnesses that may compromise one’s immune system. And it’s affected by the environment, including things like demographics, socioeconomic and climatic factors.”
Clearly, some of these factors can lead to a rise in the trajectory while others could help suppress it. But, in our case, none of it will — for the most part — be guided through rational policy. In other words, if the curve rises, there’s not much we can do except wait for herd immunity to kick in while x numbers die; if it begins to flatten, it won’t be because we managed some scientific intervention to that end.
Put bluntly, we are exposed.
That said, and knowing how feeble our policy responses would be in this round, are there any lessons? Surely, destruction of any kind should also be a learning curve. Rethinking the idea of security and broadening its definition. Pathogens cannot be stopped through a military response. If anything, they can stretch the militaries and law enforcement. They are fought, foremost, in the labs by people wearing white coats.
These people do unsexy work. You can’t put them on a float at a useless 23rd March parade; they can’t do a thrilling aerobatics show or skydive from 10,000 feet; hell, they can’t even march and salute you. They don’t wear flight suits or camouflage.
But they are the real saviours. How many of them we have here? I wonder. How many labs are doing cutting-edge biotech research, nanotech, genetics et cetera. I really wonder.
And if there are not many, which is what I suspect, then we need to go back to our schools and take a good, hard look at both our syllabi and our teaching methods. Are we nurturing talent that will give us these leaders? Have we invested in this? Ditto for the health sector. Statistics about how many beds, ICUs and ventilators we currently have are just one glimpse into what we have, or do not. There are several other factors underlining this pathetic state.
What’s ironic is that, as the world is unfolding, we can’t even have traditional, hard security if we do not begin investing in these two sectors.
I don’t know what the toll of Covid-19 will be. But this too will pass. What will stay, however, will be the lessons we have learned. If we go back to navel-gazing, as normally happens, we will be even less prepared for the next threat.
The writer is a former News Editor of The Friday Times and hates elusive pathogens. He reluctantly tweets @ejazhaider